UR Specialist: Optimize Care Funding & Compliance

Pyramid Healthcare; Allentown (Lehigh County); Vor Ort; USD 23.000 - 32.000; Vollzeit

Benefits dieser Stelle

Medical Insurance

Dental Insurance

Vision Insurance

401(k) with Company Match

Paid Time Off

Zusammenfassung

Pyramid Healthcare is seeking a Utilization Review professional to perform admission, stay, and discharge reviews for managed care clients. You will maintain ASAM requirements, ensure insurance eligibility, and coordinate with counselors and the Billing Department.

Required are an Associate Degree (or higher) and 3-5 years in Utilization Review within healthcare. Strong Excel and data-entry skills are essential for daily reporting and documentation.

Qualifikationen

• Associate Degree or equivalent required.
• Bachelor of Science in Behavioral Health preferred.
• 3-5 years’ experience in Utilization Review or related position in a healthcare setting.

Aufgaben

• Perform admission, continued stay and discharge reviews for managed care clients.
• Maintain ASAM and eligibility data; coordinate with counselors and billing.
• Monitor census and funding and report to Assessment Manager weekly.
• Reduce client balances and manage self-pay and copays.

Kenntnisse

Utilization Review

MS Office

Excel

Data entry

Ausbildung

Associate Degree

Bachelor of Science in Behavioral Health

Tools

Excel

Microsoft Office

Jobbeschreibung

Pyramid Healthcare is seeking a Utilization Review professional to perform admission, stay, and discharge reviews for managed care clients. You will maintain ASAM requirements, ensure insurance eligibility, and coordinate with counselors and the Billing Department.

Required are an Associate Degree (or higher) and 3-5 years in Utilization Review within healthcare. Strong Excel and data-entry skills are essential for daily reporting and documentation.